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Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review

Leukemia volume 20, pages 1717–1722 (2006)Cite this article

Abstract

Intensified chemotherapy regimens resulting in improved survival of children with acute lymphocytic leukemia (ALL) lead to concerns about therapy-induced immune damage reflected by the loss of protection of previous immunizations and the efficacy of (re-)vaccination. The severity of secondary immunodeficiency, however, is not clear and knowledge is based on a limited number of studies. We performed a systematic review on literature concerning vaccination data of children with ALL published since 1980. Eight studies fulfilled the inclusion criteria. Regarding antibody titers after treatment, the number of children who had preserved the defined protection level for antibodies differed widely, ranging from 17 to 98% for diphtheria, 27 to 82% for Bordetella pertussis, 20 to 98% for tetanus, 62 to 100% for poliomyelitis, 35 to 100% for Haemophilus influenzae type B (HiB), 29 to 92% for mumps, 29 to 60% for measles and 72 to 92% for rubella. Most patients however responded to revaccination, demonstrating immunological recovery. Although the designs and results of the included studies varied widely, it can be concluded that cytostatic therapy for ALL in children results in a temporarily reduction of specific antibody levels. Memory is preserved but revaccination may be warranted. This is the first systematic review and the best possible current approximation of chemotherapy-induced immune damage in children after ALL treatment.

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Authors and Affiliations

  1. Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands

    C M van Tilburg, E A M Sanders, T F W Wolfs & M B Bierings

  2. Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands

    M M Rovers

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  1. C M van Tilburg
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  2. E A M Sanders
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  3. M M Rovers
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Correspondence to C M van Tilburg.

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Appendix A.

Appendix A.

Search strategy:

Antibody Formation OR Immunocompetence OR Diphtheria Toxoid OR Pertussis Vaccine OR Tetanus Toxoid OR Poliovirus Vaccines OR Haemophilus Vaccines OR Mumps Vaccine OR Measles Vaccine OR Rubella Vaccine OR humoral immunity* AND Neoplasms OR Cancer NOT Stem Cell Transplantation Limits.

All Child: 0–18 years, Publication Date from 1980, English, Humans.

*Please note that ‘humoral immunity’ is not a MESH term but was used as a text word.

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van Tilburg, C., Sanders, E., Rovers, M. et al. Loss of antibodies and response to (re-)vaccination in children after treatment for acute lymphocytic leukemia: a systematic review. Leukemia 20, 1717–1722 (2006). https://doi.org/10.1038/sj.leu.2404326

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  • DOI: https://doi.org/10.1038/sj.leu.2404326

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